Tags

Type your tag names separated by a space and hit enter

Human Milk Fortification with Bovine Colostrum Is Superior to Formula-Based Fortifiers to Prevent Gut Dysfunction, Necrotizing Enterocolitis, and Systemic Infection in Preterm Pigs.
JPEN J Parenter Enteral Nutr. 2019 02; 43(2):252-262.JJ

Abstract

BACKGROUND

Fortification of donor human milk (DHM) is required for optimal growth of very preterm infants, but there are concerns of more gut dysfunction and necrotizing enterocolitis (NEC) when using formula-based fortifiers (FFs), especially soon after birth. Intact bovine colostrum (BC) is rich in nutrients and bioactive factors, and protects against NEC in preterm pigs. We hypothesized that fortification of DHM with BC is superior to FFs to prevent gut dysfunction and infections when provided shortly after preterm birth.

METHODS

Two FF products, Enfamil (ENF; intact protein, vegetable oil) and PreNAN+Nutrilon (NAN; extensively hydrolyzed protein, maltodextrin), were compared with BC as fortifier to DHM fed to preterm pigs for 5 days.

RESULTS

Relative to the DHM+BC group, DHM+FF groups had higher diarrhea score and lower hexose uptake and lactase activity, and specifically the DHM+NAN group showed higher gut permeability, NEC score, more mucosa-adherent bacteria with altered gut microbiota structure (ie, lower diversity, increased Enterococcus, decreased Staphylococcus abundance). Both DHM+FF groups showed higher expression of intestinal cytokine and inflammation-related genes, more gut-derived bacteria in the bone marrow, lower density of mucin-containing goblet cells, and slightly higher colon lactate, stomach pH and acetate, and blood neutrophil-to-lymphocyte levels than the DHM+BC group.

CONCLUSIONS

Used as a fortifier to DHM, BC is superior to FFs to support gut function, nutrient absorption, and bacterial defense mechanisms in preterm pigs. It is important to optimize the composition of nutrient fortifiers for preterm infants fed human milk.

Authors+Show Affiliations

Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.Institute of Nutritional Science, Justus-Liebig-University Giessen , Giessen, Germany.Department of Biology, University of Copenhagen, Copenhagen, Denmark.USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark. Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29992630

Citation

Sun, Jing, et al. "Human Milk Fortification With Bovine Colostrum Is Superior to Formula-Based Fortifiers to Prevent Gut Dysfunction, Necrotizing Enterocolitis, and Systemic Infection in Preterm Pigs." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 43, no. 2, 2019, pp. 252-262.
Sun J, Li Y, Pan X, et al. Human Milk Fortification with Bovine Colostrum Is Superior to Formula-Based Fortifiers to Prevent Gut Dysfunction, Necrotizing Enterocolitis, and Systemic Infection in Preterm Pigs. JPEN J Parenter Enteral Nutr. 2019;43(2):252-262.
Sun, J., Li, Y., Pan, X., Nguyen, D. N., Brunse, A., Bojesen, A. M., Rudloff, S., Mortensen, M. S., Burrin, D. G., & Sangild, P. T. (2019). Human Milk Fortification with Bovine Colostrum Is Superior to Formula-Based Fortifiers to Prevent Gut Dysfunction, Necrotizing Enterocolitis, and Systemic Infection in Preterm Pigs. JPEN. Journal of Parenteral and Enteral Nutrition, 43(2), 252-262. https://doi.org/10.1002/jpen.1422
Sun J, et al. Human Milk Fortification With Bovine Colostrum Is Superior to Formula-Based Fortifiers to Prevent Gut Dysfunction, Necrotizing Enterocolitis, and Systemic Infection in Preterm Pigs. JPEN J Parenter Enteral Nutr. 2019;43(2):252-262. PubMed PMID: 29992630.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Human Milk Fortification with Bovine Colostrum Is Superior to Formula-Based Fortifiers to Prevent Gut Dysfunction, Necrotizing Enterocolitis, and Systemic Infection in Preterm Pigs. AU - Sun,Jing, AU - Li,Yanqi, AU - Pan,Xiaoyu, AU - Nguyen,Duc Ninh, AU - Brunse,Anders, AU - Bojesen,Anders M, AU - Rudloff,Silvia, AU - Mortensen,Martin S, AU - Burrin,Douglas G, AU - Sangild,Per T, Y1 - 2018/07/10/ PY - 2017/10/13/received PY - 2018/06/04/revised PY - 2018/06/05/accepted PY - 2018/7/12/pubmed PY - 2020/8/20/medline PY - 2018/7/12/entrez KW - donor human milk KW - growth KW - inflammation KW - microbiota KW - necrotizing enterocolitis KW - nutrient fortification KW - preterm infants KW - protein KW - systemic infection SP - 252 EP - 262 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 43 IS - 2 N2 - BACKGROUND: Fortification of donor human milk (DHM) is required for optimal growth of very preterm infants, but there are concerns of more gut dysfunction and necrotizing enterocolitis (NEC) when using formula-based fortifiers (FFs), especially soon after birth. Intact bovine colostrum (BC) is rich in nutrients and bioactive factors, and protects against NEC in preterm pigs. We hypothesized that fortification of DHM with BC is superior to FFs to prevent gut dysfunction and infections when provided shortly after preterm birth. METHODS: Two FF products, Enfamil (ENF; intact protein, vegetable oil) and PreNAN+Nutrilon (NAN; extensively hydrolyzed protein, maltodextrin), were compared with BC as fortifier to DHM fed to preterm pigs for 5 days. RESULTS: Relative to the DHM+BC group, DHM+FF groups had higher diarrhea score and lower hexose uptake and lactase activity, and specifically the DHM+NAN group showed higher gut permeability, NEC score, more mucosa-adherent bacteria with altered gut microbiota structure (ie, lower diversity, increased Enterococcus, decreased Staphylococcus abundance). Both DHM+FF groups showed higher expression of intestinal cytokine and inflammation-related genes, more gut-derived bacteria in the bone marrow, lower density of mucin-containing goblet cells, and slightly higher colon lactate, stomach pH and acetate, and blood neutrophil-to-lymphocyte levels than the DHM+BC group. CONCLUSIONS: Used as a fortifier to DHM, BC is superior to FFs to support gut function, nutrient absorption, and bacterial defense mechanisms in preterm pigs. It is important to optimize the composition of nutrient fortifiers for preterm infants fed human milk. SN - 1941-2444 UR - https://www.unboundmedicine.com/medline/citation/29992630/Human_Milk_Fortification_with_Bovine_Colostrum_Is_Superior_to_Formula_Based_Fortifiers_to_Prevent_Gut_Dysfunction_Necrotizing_Enterocolitis_and_Systemic_Infection_in_Preterm_Pigs_ L2 - https://doi.org/10.1002/jpen.1422 DB - PRIME DP - Unbound Medicine ER -